Letter from the Director

It’s exciting to think how far Psychiatry Residency Spokane has come in the past three years. We are really proud of the work we have done so far, and are committed to continuing to strive for excellence in patient care and education. We are a community program that is built for the emerging healthcare delivery system, with strong medicine and neurology training, consult liaison exposure and an embedded collaborative care focus beginning in PGY2 and threaded through the next three years of training. You will graduate from this program with robust clinical skills, an ability to provide outcome based treatment, and longitudinal experience working in a population based treatment model, within a patient-centered care delivery system. You also will have meaningful and longitudinal experience in working with residents and colleagues from other medical specialties.

We have established clinical, collegial, professional, and education-focused relationships with a diverse set of sites. Providence Sacred Heart Medical Center – our sponsoring institution – provides the setting for inpatient, emergency and consultation liaison psychiatry experience. Eastern State Hospital is a unique State Psychiatric Hospital setting in which residents do inpatient and forensic psychiatry. The Veterans Administration Medical Center provides rotations in neurology and neuropsychology, as well as elective experiences in evidence-based psychotherapies. We partner with Gonzaga University to provide therapy to both undergraduate and graduate students in an expanding university health system. We have close collaboration with Frontier Behavioral Health – a community mental health clinic – for outpatient child and adolescent training and geriatric psychiatry.

Spokane has a mature Graduate Medical Education department which oversees residency programs in Family and Internal Medicine, Radiology, Transitional Medicine and Rural Family Medicine. This enables residents to form a close-knit educational community with fellow residents, as well as trainees in Pharmacy (Washington State University), Social Work (Eastern Washington University) and Physical and Occupation therapy (Eastern Washington University).

The year 2016 was an exciting time for residency outpatient education with the opening of a newly built clinic on the Washington State University campus – the Spokane Teaching Health Clinic. This fully integrated clinic is fulfilling its two main aims: a focus on excellence in clinical care, and true integration in primary care specialties embedded with pharmacy, legal aid, physical and occupational therapy, social work, and on-site laboratory services and imaging.

Spokane is truly a rapidly expanding center of medical education. There is a thriving university district, two community colleges, two private universities, and three state universities, with a new medical school at Washington State University welcoming its inaugural class in August 2017.

Why choose Spokane for psychiatry residency training? Frankly, we believe that we have been training and will continue to train excellent clinicians who have a well-rounded set of skills that enable them to transition into independent practice or to pursue a variety of fellowships. Our smaller-city size and community focused training allows for a more personal feel, balances independence and maturing skills with support, allows for a responsive feedback model and changes nimbly to respond to a rapidly emerginghealthcare delivery system.

Most importantly, Spokane is a wonderful place to live. I came to this city over a decade ago to train in psychiatry, with no particular focus on staying long term. But like many other people, I quickly saw the benefits of this city and its surrounding region as a place to shape my career as well as raise a family. I absolutely intentionally live and work here, and I find myself loving it more and more each year.

Tanya Keeble, MDProgram DirectorPsychiatry Residency Spokane

Program History

Updated April 2017

This program is a mix of the old and new in Spokane. Psychiatry residency education began in 1992, as a two-year Regional Clinician Educator Track of the University of Washington Psychiatry Residency. The UW Spokane Track began with the goal of developing a psychiatric workforce in Eastern Washington, and it was very successful, retaining nearly 50% of its graduates to the greater Spokane area in its last 5 years.

Over time, it became evident that Spokane had the systems, clinical sites and rotations in place to support a four-year program. Paired with a strong local desire to support the program entirely in Eastern Washington, work began in 2012 on a locally sponsored psychiatry residency program. By 2014, the program was awarded initial accreditation by the ACGME to start a new four-year psychiatry residency program in Eastern Washington, sponsored by Providence Sacred Heart Medical Center, and affiliated with the University of Washington. The program continues to have a close, collaborative relationship with the UW, working together to develop an expanding mental health workforce for Washington state.

Psychiatry Residency Spokane is one of only two ACGME accredited psychiatry residency programs in Washington state, and one of three in the entire five-state Northwest region (Washington, Wyoming, Alaska, Montana, Idaho). The inaugural class of three residents entered in June 2015. In 2016 the program secured continued accreditation status through the ACGME. The program is expanding its class size for 2018-19 to four residents per year.

The program has come a long way in the three short years since its creation. It has developed new inpatient and consult liaison teaching services, which stand separate from the hospitalist model in Providence Sacred Heart; the program hired dedicated clinical and teaching faculty, and has moved into a new integrated teaching clinic – the Spokane Teaching Health Clinic – on the Washington State University Spokane campus. In the 2017-18 year, the program will start a collaborative care medication assisted treatment clinic for patients with opioid misuse disorder, and will begin outreach out to several Providence primary care locations in order to bring psychiatry consultation through integrated care psychiatry expertise to the most vulnerable and underserved in our communities.

Our Mission

Providence Psychiatry Residency Spokane was developed with three overarching goals: to develop a regional psychiatric workforce to serve the needs of Spokane, Washington state and the WWAMI region; to train graduates who are accomplished and innovative educators and clinicians; and to graduate residents who hold a deep commitment and passion for serving the poor and vulnerable.

We have a strong emphasis on training residents who are prepared for a changing healthcare delivery model, with an outpatient focus on integrated psychiatric care within a primary care setting and strong hospital-based consultation training. Residents have extended exposure to the breadth of community psychiatric needs, including geriatric, forensic, addiction and child psychiatry settings. Our graduates will be able to competently serve their respective communities, whether they decide to pursue fellowship opportunities in these areas or not.

Providence Psychiatry Residency Spokane is committed to providing residents with strong psychotherapy training, with specific expertise in teaching intensive short-term dynamic psychotherapy (ISTDP). There is a particular emphasis on integrating and balancing psychopharmacology with psychotherapy, with the knowledge that both modalities are more effective and cost efficient when combined. With a particular focus on primary care psychiatry, we are moving into development of short-term primary care based psychotherapy training, with every resident required to train to coded competency in motivational interviewing, in addition to cognitive behavioral and supportive therapy training.

Spokane provides a residency education that prepares physicians to care for the underserved, manage complex psychiatric conditions, often comorbid with severe medical illness, learn psychotherapy in a real world, community based setting, and practice in the latest healthcare delivery systems.